Erythroleukemia: a need for a new definition

Abstract

The new WHO classification abolishes the frontier between RAEB-t with 20% of blasts and leukemia with 30% of blasts. We review the definitions of erythroleukemia and discuss the relationship between FAB AML6, RAEB-t and AML6 variant. We ask whether secondary erythroleukemias are the same entity as RAEB-t on survival, karyotype and cytologic characteristics. We suggest that 'AML6 variant' with pure erythroid lineage proliferation would be the real de novo erythroleukemia. Current FAB AML6 entity will probably be classified in either subgroup (1) multilineage dysplasia; (2) therapy-related leukemia; or (3) acute erythroid leukemia subdivided into erythroleukemia (erythroid/myeloid) and pure erythroid leukemia, in the WHO classification -a classification which highlights the importance of clinical and cytogenetic prognostic factors.

Pure erythroid leukemia: a reassessment of the entity using the 2008 World Health Organization classification

“…We showed in our cases that PEL is indeed of a 'true erythroleukemia' where proliferation and differentiation are both affected, akin to the double-hit models proposed to underlie other types of AML with recurrent genetic abnormalities. [19][20][21] Conversely, while AEL is also a clonal stem cell neoplasm, the erythroblasts in AEL are dysplastic but still capable of differentiating. In fact, we and others have shown that AEL and MDS with erythroid predominance are a continuum where karyotype rather than an arbitrary myeloblast cutoff represents the most important prognostic factor in this group of myeloid neoplasms.…”

Evaluation of CD71 Expression in Acute Leukemia in Egyptian Patients

“…Both Park et al . [35] and Liu et al [28] also demonstrate that acute erythroblastic leukemia (AEL) patients do not necessarily express CD71 on their leukemic cells (included myeloblasts and erythroblasts) i.e. CD71 is not a specific and/or reliable marker for AEL.…”

A case of erythroleukaemia in an eight year old boy

“…Median disease-free survival reported was 32 weeks and median period of overall survival was 36 weeks. Others have reported a median survival from 3.5 to 77 months 8 .…”

“…Megakaryocytes in erythroleukaemia are very often dysplastic with abnormalities of segmentation of the nucleus of or abnormalities of size (micromegakaryocytes) 8 . Pawn ball megakaryocytes seen in our case are probably a feature of severe myelodysplasia Management of AML (including M6 subtype) constitutes induction chemotherapy and postinduction/consolidation chemotherapy.…”